Epstein-Barr Virus (EBV) Acute Infection Antibodies Profile

Additional Information:

Epic order code: LAB863

Epstein-Barr (EB) virus is a herpes group virus that is ubiquitous. It is the cause of classic infectious mononucleosis and is causally implicated in the pathogenesis of Burkitt lymphoma, some nasopharyngeal carcinomas, and rare hereditary lymphoproliferative disorders. The serologic response to EB virus includes antibody to early antigen, IgM and IgG antibodies to viral capsid antigen (VCA), and antibodies to Epstein-Barr nuclear antigen (EBNA).

Although most cases of infectious mononucleosis can be diagnosed on the basis of clinical findings, blood count and morphology, and a positive test for heterophil antibody, as many as 20% may be heterophil-negative, at least at presentation (Heterophil may become positive when repeated in a few days.). In some of these cases, a test for Epstein-Barr virus antibodies may be useful.

The most controversial use of EBV serology is in chronic fatigue syndrome, a complaint predominantly (but not exclusively) of young to middle-aged women, characterized by long persistent debilitating fatigue and a panoply of usually mild somatic complaints. The high levels of EBV antibodies in the general population, their long persistence, and the poor correlation of antibody titers with symptoms combine to make EBV serology useless in diagnosing, following, or ruling out chronic fatigue syndrome. See the EBV Interpretation Table below.

EBV Interpretation Table







  • Antibody present: +
  • Antibody absent:

EBV Seronegative

Early phase


Acute primary infection




Convalescence/past infection




Reactivated infection





CPT Code(s):

86663, 86664, 86665 (x 2)

Specimen Requirements:

Type: Serum

Container/Tube: Red-top tube or gel-barrier tube

Sample Volume: 2 mL

Minimum Volume: 1 mL

Storage: Refrigerate specimens immediately after collection.

Stability (collection to time of analysis/testing):

  • Ambient: 2 days
  • Refrigerated: 2 days
  • Frozen: > 2 days


This test is used in the differentiation of acute from chronic or reactivated infections with Epstein-Barr virus. It includes:


Chemiluminescent immunoassay (CLIA)